Advanced Reports

Overview

For Premier report information, contact EZClaim.

Standard reports are marked with a checkmark and are pre-installed with EZClaim. Standard reports do not have a download link.

Additional downloadable reports are marked with a download and will be added to your report list after installed.

windnows Vista or Windows 7 Users: Report updates must be run as the Administrator. Save the update to your desktop, right click the file, and select Run as Administrator (screen shot).

Click the report type below to jump directly to that section:

Aging Reports
Authorization Reports
Claim List Reports
Custom Reports
Patient List Reports
Patient Receipt Reports
Patient Visits Reports
Payment Reports
Statements
Statements/Receipts for Nelco Perforated Forms
Other Reports

Statements

checkmarkStatement - Sample - Standard statement showing charges, payments, and aging. Will only print if the patient has a balance due. Shows all transactions from claims not check marked as 'Paid'.

downloadStatement for BillFlash Export - Standard statement used with the BillFlash electronic statement service.  See our BillFlash web page for more information.

downloadStatement with only Patient Balances - Sample - Standard statement but will only show service lines that have the responsible party set to '3 - Patient', the claim is not archived, and the claim's 'Paid' check box is unchecked.

downloadStatement Summary - Sample - Single line statement showing the total charges, insurance payments and adjustments, insurance balance, patient payments, and patient balance.

downloadStatement w No Return Address Sample - Standard statement with no return address.

downloadStatement w Balance Forward - Sample - Asks for a balance forward date and will total all the previous balances as a single line item.

downloadStatement w Balance Forward no Tax ID Sample - Asks for a balance forward date and will total all the previous balances as a single line item.

downloadStatement with Payment Notes Sample - Payment notes will print on the statement below the payment. MUST be running Advanced 7 Release 27 or higher.

downloadStatement with Return Slip no Diags no Tax ID no Phone Number Sample - Statement report with a return slip. No diagnostic codes, no Tax ID, and no phone number.

downloadStatement with Return Slip and patient grouping. Sample - Statement report with a return slip and patient grouping. (e.g. A-L)

downloadStatement for Payer Billing Sample - Statement report with a return slip. Shows the Payer address on the left and the patient name on the right. Updated 3/20/2006 to allow a date range to be entered.

downloadStatement with Return Slip no Diags no Tax ID Sample - Statement report with a return slip. No diagnostic codes are shown. The Tax ID is not shown.

download Statement with Return Slip no Diags no Tax ID using a Date Range - Sample - Statement with date range report with a return slip. No diagnostic codes are shown. The Tax ID is not shown.

download Statement for Self Pay Patients no Tax ID Sample - Statement for Self Pay Patients without the Tax ID.

downloadStatement with Return Slip no Diags Sample - Statement report with a return slip. No diagnostic codes are shown.  'Bill To' field available (more info).

downloadMonthly Statements Sample - Monthly statements will print even if the patient has a zero balance and no matter what the Balance - Responsible Party is set to. The statement will print data from all claims 'not archived' and 'not paid'. The provider Tax ID is removed and the diagnostic codes are removed.

downloadStatement for All Unpaid Claims Sample - Statement report showing all service line data from claims not marked as paid.

downloadStatement with Facility Return Address - Sample - Statement report with Facility Return Address.

downloadStatement with Facility Return Address with Pmt Ref 1 and 2 Fields - Statement report with Facility Return Address including payment ref 1 and 2 fields.

downloadStatement with Return Slip Sample - Statement report with a return slip to cut off and return with payment.  'Bill To' field available (more info).

downloadStatement using Date Range Sample - Statement report that allows the use of dates ranges.

downloadStatement w No Tax ID or Phone Sample - Statement report without the providers tax ID and phone number listed. Updated to include the second address line for the return address.

downloadStatement with Payment Reference 1 and 2 Fields Sample - Statement that shows the reference 1 and reference 2 fields from the Payments/Adjustments window.

downloadStatement with Return Slip no Diags with Pmt Ref 1 and 2 Fields Sample - Statement that shows the reference 1 and reference 2 fields from the Payments/Adjustments window and contains a Payment Slip with no diagnostic codes.

downloadStatement with Return Slip no Diags no Procedure with Pmt Ref 1 and 2 Fields Sample - Statement that shows the reference 1 and reference 2 fields from the Payments/Adjustments window and contains a Payment Slip with no diagnostic codes and no procedure codes.

downloadStatement with Return Slip no Diags no Procedure with Pmt Ref 1 and 2 Fields no Tax IDSample - Statement that shows the reference 1 and reference 2 fields from the Payments/Adjustments window and contains a Payment Slip with no diagnostic codes and no procedure codes and no Tax ID.

downloadStatement for Self Pay Patients Sample - Statement report without the insurance information. This statement ignores the responsible party setting and assumes all balances are the responsibility of the patient.

downloadStatement for Self Pay Patients with Ref Fields 1 and 2 Sample - Statement for Self Pay Patients with payment reference fields 1 and 2.

downloadStatement w No Tax ID Sample - Statement report without the providers tax ID listed. Updated to use the reason code description for contract adjustments. Updated to include the second address line for the return address.

downloadStatement no Diags Sample - Statement report without the diagnostic codes.

Statements/Receipts for Nelco Perforated Forms

Nelco's web site

Nelco Statements can include change of address and credit card payment details. See the Nelco web site for more information. Only use the statement forms that are marked 'Perf at 3 1/2" from top.'

downloadStatement for Nelco Perforated Forms - 'Bill To' field available (more info).

downloadStatement for Nelco Perforated Forms No Tax ID - 'Bill To' field available (more info).

downloadStatement for Nelco Forms no Diags - 'Bill To' field available (more info).

downloadStatement for Nelco Forms no Diags no Proc - 'Bill To' field available (more info).

downloadStatement for Nelco Forms no Diags no Tax ID - 'Bill To' field available (more info).

downloadStatement for Nelco Forms w Balance Forward - 'Bill To' field available (more info).

downloadStatement for Nelco Forms w Balance Forward no Tax ID - 'Bill To' field available (more info).

downloadPatient Receipt for Nelco Perforated Forms - 'Bill To' field available (more info).

downloadPatient Receipt for Nelco Perforated Forms No Tax ID - 'Bill To' field available (more info).

 

Claim List Reports

checkmark Claim List - Sample - List showing claim totals. Grouped and subtotaled by Patient Group.

download Claim List with Outstanding Balance - Shows claims that have an outstanding balance.

download Claim List Detail by Rendering Provider - Sample - Shows patient name, ID number, service date, procedure, units, charges, co-pay, insurance payment, and adjustment. Grouped by rendering provider, patient, then claim. Includes the patient visit count.

download Claim List with Credit Balance - Sample - Shows claims that have a credit balance.

download Claim List sorted by 1st Claim Date - Sample - Same as the Claim List report but sorts by the 1st date of service instead of the patient name.

download Claim List by Payer - Sample - Claim List report grouped and subtotaled by Primary Payer.

download Claim List Detail by Payer - Sample - Shows patient name, ID number, service date, procedure, units, charges, co-pay, insurance payment, and adjustment. Grouped by payer, patient, then claim. Includes the payer phone number.

download Claim List Detail by Facility - Sample - Same as Claim List Detail but grouped and subtotaled by Facility.

download Claim List Detail - Sample - Fixed an issue where patient names are shown even if they do not have a middle initial. Same as the Claim List report but shows service line detail along with the diagnostic codes. Now uses patients' middle initial.

download Claim List by Rendering Provider - Sample - Claim grouped and subtotaled by rendering provider.

download Claim List with Orig Ref No - Claim List showing the Original Reference Number.

Aging Reports

checkmark Accounts Receivable Report - Sample- AR report showing outstanding charges, credits, and open balance to the patient, primary and secondary insurances. Includes last charge, last payment, and aging. Can double click to drill down and see detail data. Each patient group is printed on a new page.

download Accounts Receivable Report by Date Range Sample - Normal AR report but allows you to use a date range.  We suggest using the Claim Bill Date as the date range source.  If you do not want to see $0.00 balance patients, select the 'Not Paid' option in the Claim Status criteria on the reports window.

download AR Report Aged to 360 -Sample - Removes charge, payment and adjustment columns. Shows aging columns out to a year.

download AR Report by Payer -Sample- Groups the data by primary payer

download AR Report Aged by Service Date -Sample- Same as the standard AR report except the aging is calculated by the service date instead of the bill date.

download AR Report Aged by Responsibility Change Date - Same as the standard AR report except the aging is calculated by the responsible party change date.

Patient Receipt Reports

checkmarkPatient Receipt - Sample - Standard receipt to print for a patient. Normally would be printed for a single claim.

downloadPatient Receipt w Balance Forward No Tax ID - Sample - Asks for a balance forward date and will total all the previous balances as a single line item. Does not show the Tax ID.

downloadPatient Receipt w Balance Forward Sample - Asks for a balance forward date and will total all the previous balances as a single line item.

downloadPatient Receipt no Diags Sample - Same as the standard patient receipt but does not show the diagnostic codes. Includes Reference 1 and 2.

downloadPatient Receipt no Diags no Tax ID Sample - Same as the standard patient receipt but does not show the diagnostic codes nor the tax ID. Includes Reference 1 and 2.

downloadPatient Receipt w Units Sample - Same as the standard patient receipt but includes the units.

downloadPatient Receipt Sample - Moved the Tax ID down so it won't show in a windowed envelope. Also shows both reference fields for each payment item.

Patient Visits Reports

checkmarkPatient Visits - Sample - Shows patient name, date, procedure, units, charges, and applied amount. Grouped and subtotaled by patient group and facility. Includes the patient visit count.

checkmarkPatient Visits Not Authorized - Sample - Shows patient name, procedure, units, charges, and applied amounts. Grouped by patient group, patient, and claim. Includes number of visits, claim ID, authorization number and detail information for services not authorized.

downloadPatient Visits by Primary Payer - Sample - The standard patient visits report grouped by primary payer.

downloadPatient Visits by Procedure - Sample - Shows the patient visits by procedure.

downloadPatient Visits with From and To Dates - Sample - Shows the 'To' date.

downloadPatient Visits Sample - Added subtotals for the number of visits.

downloadPatient Visits by Referring Provider Sample - Shows the number of visits and the last time the patient was seen grouped by referring provider.

downloadPatient Visits by Billing Provider Sample - The standard patient visits report grouped by billing provider (Box 33).

Patient List Reports

checkmarkPatient List - Sample - Shows the patient name, phone, last date of service, ID number, account number, status, and balance. Grouped by patient group.

downloadPatient List by Secondary Payer - Sample - Standard patient list grouped by the secondary payer if entered.

downloadPatient Balances - Sample - Standard patient list report that only shows patients with a balance.  Hides patients without a balance.

downloadPatient List by Plan Name - Sample - Standard patient list report but grouped by Insured Plan Name field.

downloadPatient ID List Sample - Shows the patient name and the ID numbers including the patient account number, insured ID, insured group, other ID, other group, and SSN.

downloadPatient Address List Sample - Shows the patient name, address, phone number, and gender.

downloadPatients Last Seen Between X and Dates Sample - Patient list showing patients last seen during a date range. When you click the Print or Preview button, the program will prompt you for the start and end dates.

downloadPatient List by Payer Sample - Standard Patient List but grouped by Payer Name instead of Patient Group.

downloadPatient List Sample - Added the patient gender and date of birth. Increased the width of the Insured's ID Number field to account for longer ID numbers. Fixed the Patient Count field to be correct if any of the patients have no claims.

downloadPatient List Detail Sample - Shows the patient address and payer information. Updated 2/8/05 to fix multiple records printing if selecting report criteria.

downloadPatients Not Seen for X Number of Months Sample - Shows a list of patients not seen within the last X months. The patient must have at least one service line so the report can calculate the last visit. If a patient does not have any service lines entered, they will not appear on the list.

Authorization Reports

downloadAuthorizations Sample - Fixes the issue of a blank report when running from the Authorization Library screen.

downloadAuthorizations by Expiration Sample - Added a user defined value to only show authorizations that are due to expire within a certain number of user defined days. Also sorts by Authorization End Date then by Patient.

downloadAuthorizations - Current Only Sample - Shows the current authorizations only.

downloadAuthorizations - Current by Payer Sample - Shows the current authorizations grouped by payer.

downloadAuthorizations - Expired or Over Units Sample - Shows the authorizations that have expired or are over the allowable units.

Payment Reports

checkmarkOther Adjustments - Sample - Shows patient name, adjustment date, amount, and the claim ID. Grouped and subtotaled by the adjustment code.

checkmarkPayments By Date - Sample - Shows patient name, claim ID, payment date, patient payment, insurance payment, secondary payment, contract adjustment and other adjustment. Grouped and subtotaled by patient group and payment date. IMPORTANT: A payment date must be entered for the payment to show on the report.

checkmarkPayments By Reference - Sample - Shows the patient name, service date, payment type, payment date, and amount. When the report is run, it will ask for the reference to show. Enter the reference number or use the * character as a wild card. Example, AB* will show all payments will a reference starting with AB.

downloadPatient Payments by Reason Code - Sample - Patient payments grouped and totaled by reason code.

downloadPayments by Reference by Rendering Provider Sample - Payments by Reference report grouped and subtotaled by rendering provider.

downloadPayments by Date by Billing Provider Sample - Payments by Date report grouped and subtotaled by billing provider.

downloadPatient Payments by Date Sample - Shows patient payments only includes the ref 1 and 2 fields plus the reason code and payment notes.

downloadPayments and Adjustments by Reason Code Sample - Shows payments and adjustments by reason code. Prompts you for a reason code to filter by.

downloadServices without Insurance Payment Sample - Basic 5 report converted to Advanced

Other Reports

checkmarkClaim Notes - Sample - Shows the patient name, and the claim notes for each claim. Also shows the first claim date, total charge, and balance due.

checkmarkDaily Summary - Sample - Shows all transactions for a date period. Includes the patient name, transaction date, code, charges, payments, and descriptions. Grouped by patient group, provider, day, and type. Subtotals by provider, day and patient group.

checkmarkDeposit Slip - Sample - Shows the patient name, payment amount, and reference number. Grouped by transaction date, reference 1, and patient name.

checkmarkPatient Ledger - Sample - Shows the patient and billing contact details, transaction date, code, description, rendering provider, and amount. Includes balance of all transactions.

checkmarkPatient Notes - Sample - Shows the patient name, ID number, account number, phone number and notes.

checkmarkProcedure Code Summary - Sample - Shows the procedure, units, charges, all payments and totals by procedure code and gives a grand total. When the report is opened, you can enter a single procedure code or use the * character as a wild card. Example, if you enter 9*, it will show all procedures starting with a 9.

checkmarkProduction Summary - Sample - Shows the production of the rendering providers. Totals the charges, contract adjustments, other adjustments, and payments by each rendering provider. Shows a percent of total for each provider.

checkmarkRecurring Claims - Sample - Shows recurring claims by patient. Columns include name, service date, procedure codes, units, and charges.

checkmarkReferring Provider Patient Count - Sample - Shows the name of the referring provider, the number of patients referred, the claim count, total charges and applied amount. Can double click to drill down and see detail data.

downloadPatient Ledger with No Payments - Same as the patient ledger but excludes payments.

downloadDiagnosis Code Summary - Lists the primary diagnosis code in order of usage.

downloadDuplicate Dates of Service - Sample - Will show duplicate service dates (same date, same procedure code, same patient).

downloadProcedure Code Summary by Rendering Provider - Sample - Procedure Code Summary report grouped by rendering provider.

downloadPatient Notes - Sample - Updated patient notes report. Suppresses patient records that do not contain notes.

downloadGeneric CMN Report - Sample - Prints a generic CMN.

downloadPhysician Library List Report - Standard Physician Library List report but includes the address.  This report will not show up in the report list.  It is accessed from the physician library screen by clicking the 'Library List Report' button.

downloadProduction Summary by Ordering Physician Sample - Uses the Ordering Physician for a production report.

downloadTransaction Totals by Month Sample - Shows totals by month for charges, payments, and adjustments.

downloadTransaction Totals by Patient Sample - Shows patient charge totals for payment totals broken down by payment/adjustment type.

downloadTransaction List Sample - Shows a list of transactions (charges and payments) grouped by patient.

downloadDaily Summary - Sample

downloadFollowups for the Month Sample - Shows the follow-ups for a certain month. The program will ask which month to print.

downloadMailing Labels - Insured - Sample - Mailing labels showing the Insured's name and address information. Uses standard single sheet mailing labels 3 across and 10 down.

downloadMailing Labels - Patient - Sample - Mailing labels showing the Patient's name and address information. Uses standard single sheet mailing labels 3 across and 10 down.

downloadMailing Labels - Patient Birthday - Sample - Monthly birthday mailing labels showing the Patient's name and address information. The program will ask for the month of the birthday.  Uses standard single sheet mailing labels 3 across and 10 down.

downloadMailing Labels - Physician Sample - Mailing labels showing the Physician's name and address information. Uses standard single sheet mailing labels 3 across and 10 down.

downloadUpdated CMNs - Will print the NPI in the Supplier and Physician areas correctly. Enter the NPI number into the Physician Library into the NPI number field. The old CMNs will print data even if no facility is selected on the Charges screen.

downloadIncome StatementSample

downloadDelivery Ticket Sample - Delivery ticket to show items and descriptions of items on the claims regardless if a Facility or a Payer were selected for that patient's claims.  The Balance After Insurance is either the Patient Amount due or if it's $0.00, the program will calculate it by taking the line item Charges and subtracting the Allowed Amount.

downloadContract Adjustments Sample - Same as the 'Other Adjustments' report but only shows contract adjustments. Grouped and subtotaled by Payer and Procedure code.

downloadReferring Provider Patient Count Sample - Shows the number of patients referred by each referring physician. Also shows the claim count. Double click the physician name to get the patient visit detail.

downloadInsurance Follow-up Report Sample - Includes insurance information and insured's details for following up with unpaid claims.

downloadCarrier Mailing Labels Sample - Prints insurance company addresses on a sheet of labels. Uses the standard 3 across, 10 down label sheets.

downloadStandard Follow-up Report without Claim Notes - Sample - Standard EZClaim follow-up report without the claim notes.  This is a special report used to show claim follow-ups.  It does not appear in the normal report list.  To run the report, click the Follow-Up Report Preview button on the Charges screen (next to the follow-up date and reference).

downloadOhio MACSIS Submission Report - Advanced 6 or 7 - Sample - Submission report from Ohio EZClaim 2.3. Users that have upgraded to version 5.0 but still want to use the older submission report should download and install this report.

Custom Reports

Arbus Business Solutions provides custom report design to satisfy any report request.